1. Field of the Invention
The present invention is related to a computerized training system for physicians, medical students, nurses and other medical professionals. In particular, the present invention relates to a system which teaches the purpose, indications, methods, complications and techniques for hemodynamic monitoring of patients.
2. Description of the Prior Art
Hemodynamic monitoring is the method whereby a patient undergoes placement of a catheter passed from a distant vein, through the heart to the pulmonary vasculature for the purposes of measuring intracardiac, pulmonary artery and wedge pressures. The measured pressure data is used by the physician to determine the type or extent of cardiopulmonary disease, to evaluate therapeutic measures, and to monitor cardiac function.
Hemodynamic monitoring is typically performed by a physician in an intensive care unit of a hospital, while caring for a critically ill patient. Among the diseases for which hemodynamic monitoring is useful are acute myocardial infarctions, heart valvular disorders, cardiomyopathies, pulmonary disorders and congenital defects.
The hemodynamic monitoring catheter is essentially a long synthetic polymer tubing which is small enough to be inserted into a peripheral vein of the body and which is long enough to extend through that vein and the heart to the pulmonary artery within the lungs. There are hollow tubes running the length within the catheter which provide a conduit for manometric measurement of the pressures within the heart and pulmonary artery. Electronic pressure transducers are connected to the end of the catheter outside the body, and these are in turn connected to an oscilloscope display which shows the instantaneous pressure data with time (i.e. a hemodynamic waveform). The catheter may also allow for simultaneous measurement of pulmonary artery and right atrial pressures. A thermister probe near the end of the catheter may be utilized for thermodilution derived measurement of the cardiac output. There is a balloon located at the distal end of the catheter that is inflated by the medical professional as the catheter enters the heart. This inflated balloon assists the catheter tip through the heart chambers into the pulmonary artery. It also may be inflated in the pulmonary artery to obtain a wedge pressure. The wedge pressure is a reflected pressure of the left chambers of the heart through the lung, rather than the direct pressures obtained from the right side of the heart as the catheter is advanced.
Traditionally, training in hemodynamic monitoring has taken place at the bedside, with a more experienced physician (often a cardiologist or internist) demonstrating the technique and methods of waveform interpretation to the inexperienced physician, medical student or nurse. The training process, therefore, has been dependent upon the availability of critically ill patients on which the inexperienced physician, medical student or nurse can practice.
Although the physical process of introducing a catheter into a patient can be simulated, in the past there has been no training system available by which physicians, medical students and other medical professionals can practice and be trained in the techniques of hemodynamic monitoring through simulation, rather than with live patients.